German patient celebrates court case victory for cannabis insurance coverage

Bethan Rose Jenkins, Cannabis News Writer/Editorial

A health insurance provider in Germany has been ordered to grant medical cannabis insurance coverage for a female patient. The petitioner, whose name has not been disclosed, is one of many patients residing in the European country who have engaged in ongoing conflicts against unwilling insurers.

Patient enrollment counts have been inflating since Germany’s medical cannabis program was launched in 2017. Based on a judge’s ruling at the Social Court of Berlin and Brandenburg, public health insurance providers must reimburse patients for the expense of their plant-based medicines.

Only in “justified, exceptional cases” will insurance providers be able to sidestep coverage opportunities for medical cannabis patients. The court also ordered the insurer to pay the patient’s legal fees. 

Female medical cannabis patient will have the cost of THC formulation covered by health insurance

The German medical cannabis patient was using a synthetic cannabinoid formulation rich in the psychoactive cannabis compound THC (tetrahydrocannabinol). Patients are commonly prescribed this type of medicine if they struggle with gastrointestinal problems, night sweats and nausea. 

Drobanol is the name of the THC-rich formulation, which will now be covered by public health insurance for an entire year. A decision was made after the court ruled that “it is undisputed that the applicant has a serious illness” and “the suffering of the applicant living on social benefits is serious.” Because of this, her “fundamental rights” would be violated if access to her medicine is restricted, the judges concluded.

Court documents were initially published by Marijuana Business Daily reporters. They clarify that the patient who is on the receiving end of a disability pension from the German government suffers from “very pronounced restless legs syndrome with massive sleep disorders, chronic pain disorder with somatic and psychological factors, migraine, recurrent depressive disorder, emotionally unstable personality disorder (borderline) and tinnitus.”

Public health insurance has fished out millions of Euros for Germany’s medical cannabis patients 

So far this year, the German National Association of Statutory Health Insurance Funds (GKV) has spent €75 million ($88.8 million) on medical cannabis expenses for patients in the European country; the GKV is responsible for affording the cost of 90 percent of Germany’s population.

Contrastingly, medical cannabis markets in the United Kingdom and the United States both of which are growing at a rapid rate do not provide funding for patients. Because of this, patients must foot the cost of their medicine. 

While Germany might be moving in the right direction with its medical cannabis insurance coverage court case, it should be noted that almost 40 percent of reimbursement applications have been dismissed since the patient program went into effect three years ago.

Advocates are optimistic that the outcome of the recent case will prompt more health insurance providers to be respectful of the the law and patients’ financial circumstances.